Advances in Social Science, Education and Humanities Research, Volume 496 Proceedings of the 2020 3rd International Conference on Humanities Education and Social Sciences (ICHESS 2020)

Investigation on The Status of Physical Development, Anemia and Caries of Preschoolers in Chongqing Wang-Yu1,a, Zeng-Yan1

1faculty of preschool education，Chongqing University of Education, Chongqing 400065,China a Email:[email protected]

ABSTRACT Period of preschool is important for children's growth and development, which has a far-reaching impact on children's health in the near and long term. The aim of this study was to understand the physical development, anemia and caries status of children aged 3-6 years in Chongqing, so as to provide reference for children health care work. The physical examination data of 2573 preschool children in Chongqing were collected by convenience sampling for descriptive analysis and difference test. The rates of growth retardation, underweight, emaciation, overweight, obesity, caries and anemia were 12.24%, 1.71%, 7.38%, 5.05%, 38.09% and 13.37%. Boys had lower rates of underweight and anemia than girls(P=0.000) .The rates of growth retardation, underweight, caries and anemia were lower in urban areas than that of in rural areas(P＜ 0.05). The regional difference of body symmetry was statistically significant. Age differences in underweight and caries were statistically significant. Physical development of preschool children in Chongqing needs to be promoted, and the incidence of common diseases was high, and effective measures should be taken to intervene. Keywords：Preschool children, Physical development, Chongqing, Caries, Anemia

children participated in the physical examination, and 2573 1. INTRODUCTION children met the inclusion criteria. Inclusion criteria: 1) Age 3-6; 2) No organic diseases; 3) No secondary obesity; 4) No Preschool is the period of rapid development which is the history of illness in the two weeks before the physical key to the growth and development of preschoolers.If examination; 5) Complete physical examination data. preschoolers cannot guarantee a balanced nutrition, 6)Informed consent was obtained from the parents. adequate physical activity and good living habits, they are prone to growth retardation, underweight, overweight, obesity and other physical development deviation, and 2.2 The diagnostic criteria and evaluation also easy to cause anemia, caries or other common methods diseases, which can affect children's current or long-term health. Physical growth measurement and evaluation of Weight-for-age （ WAZ ） below -2S is considered preschoolers is the most convenient, economical and underweight， and height for age（HFA）below -2S is non-invasive method for monitoring and intervening the considered growth retardation. Height and weight standards health and nutritional status of individual and group refer to the reference standard for growth and development children. The purpose of this study is to understand the of children under 7 years old. physical development of children aged 3-6 years in Body mass index(BMI) was used to assess body symmetry. Chongqing, and to provide reference for the health care BMI criteria refer to the percentile scale of body mass index work of preschoolers in Chongqing. of Chinese children aged 2 to 18 years in 2009. BMI below the 3rd percentile (P3) of the same age and gender is considered as emaciation;BMI higher than the 85th 2. OBJECT AND METHODS percentile (P85) of the same age and gender and lower than the 95th percentile (P95) is considered overweight.BMI higher than the 95th percentile (P95) of the same age and 2.1 Object gender is considered obese[1]. The criteria of anemia refer to the diagnostic criteria of the 13 kindergartens were selected from in Nanan district, eighth edition of Pediatrics[2]. Hemoglobin (Hb) < 110g/L Yuzhong district, Liangjiang new district, Jiangbei at 6-59 months and Hb <115g/L at 5-11 years old were district, Wanzhou district and Wushan county by diagnosed as anemia. convenience sampling. The physical examination data of The criteria for caries refer to the methods of the 4th national all children in the kindergarten were collected, and 2763 oral health epidemiological survey in 2015 and the 5th

Copyright © 2020 The Authors. Published by Atlantis Press SARL. This is an open access article distributed under the CC BY-NC 4.0 license -http://creativecommons.org/licenses/by-nc/4.0/. 371 Advances in Social Science, Education and Humanities Research, Volume 496

edition oral health epidemiological survey by the world 3. Results health organization in 2013[3].

3.1 The Basic Information of The Object 2.3 Statistical Method 2753 children met the inclusion criteria,including 1267 SPSS20.0 was statistically analyzed. Composition ratios males and 1306 females, with 1270 children in the urban and or rates were used for statistical description of 1303 in the rural,see table1. data.Chi-square tests were used to compare differences in composition ratios or rates. Bonferroni test was used for pairwise comparison. P < 0.05 was considered statistically significant. Table 1. The basic information of the object

Gender Areas Age Total Male Female Urban Rural 3.0~ 802(31.17%) 418(52.12%) 384(47.88%) 428(53.37%) 374(46.63%) 4.0~ 899(34.94%) 447(49.72%) 452(50.28%) 416(46.27%) 483(53.73%) 5.0~ 872(33.89%) 402(46.10%) 470(53.90%) 426(48.85%) 446(51.15%) Total 2573(100.00%) 1267(49.24%) 1306(50.76%) 1270(49.36%) 1303(50.64%) Note:5.0~ on behalf of 5~6 respectively. There was no significant difference in body 3.2 Physical Development Deviation of symmetry among different age and gender. Regional Preschoolers of Different Genders , Areas differences in body symmetry were statistically significant(2=48.30,P=0.000). The rates of emaciation and and Ages obesity in urban children was higher than that in rural. See table2. The growth retardation rate was 13.06%. There was no significant difference in growth retardation rate among different ages and genders. The growth retardation rate (4.41%)in urban areas was lower than that in rural 3.4 Incidence of Caries and Anemia of areas(21.49%), and the difference was statistically Preschoolers of Different Genders, Areas and significant(2=165.25,P=0.000).See tableⅡ. Ages The underweight rate was 12.24%.The underweight rates in males(9.87%) and urban (8.03%) were lower than The dental caries rate was 38.09%.There was no significant those of females(14.55%) and rural (16.35%), with difference in dental caries rate among different genders.The statistically significant(2=13.12 and 41.39,P=0.000).The rate of dental caries in urban (32.20%)was lower than that in difference of underweight rate among different ages was rural(43.82%), and the difference was statistically statistically significant(2=18.21,P=0.000).The rate of significant(2=36.81,P=0.000). The rate of dental caries in underweight among 5 years old was higher than that different age groups was statistically among 3 years and 4 years old children, respectively. See significant(2=9.31,P=0.010). 5 years old children dental table2. caries rate was higher than 3 years old children.See table2. The anemia rate was 13.37%. There was no significant difference in anemia rate among different ages. The anemia 3.3 Body Symmetry of Preschoolers of rate in male(10.66%) and urban area(6.06%) was lower than Different Genders, Areas and Ages that in female(16.00%) and rural area(20.49%), respectively, and the difference was statistically significant(2=15.88 and The proportion of children who are emaciation, 115.60,P=0.000). See table2. overweight and obese were 1.71%,7.38% and 5.05%,

Table 2. comparison of physical development deviation and common disease detection in different gender, ages and areas (n, %)

Growth Dental Items Groups Sample size Underweight Emaciation Overweight Obese Anemia Retardation Caries male 1267(49.24%) 180(14.21%) 125(9.87%) 27(2.13%) 90(7.10%) 60(4.74%) 464(36.62%) 135(10.66%) Genders female 1306(50.76%) 156(11.94%) 190(14.55%) 17(1.30%) 100(7.66%) 70(5.36%) 516(39.51%) 209(16.00%)

372 Advances in Social Science, Education and Humanities Research, Volume 496

total 2573(100.00%) 336(13.06%) 315(12.24%) 44(1.71%) 190(7.38%) 130(5.05%) 980(38.09%) 344(13.37%) 2 2.90 13.12 3.36 2.28 15.88 P 0.089 0.000 0.340 0.132 0.000 urban 1270(49.36%) 56(4.41%) 102(8.03%) 44(3.46%) 100(7.87%) 68(5.35%) 409(32.20%) 77(6.06%) rural 1303(50.64%) 280(21.49%) 213(16.35%) 0(0.00%) 90(6.91%) 62(4.76%) 571(43.82%) 267(20.49%) Areas total 2573(100.00%) 336(13.06%) 315(12.24%) 44(1.71%) 190(7.38%) 130(5.05%) 980(38.09%) 344(13.37%) 2 165.25 41.39 48.30 36.81 115.60 P 0.000 0.000 0.000 0.000 0.000 3.0~ 802(31.17%) 105(13.09%) 94(11.72%) 14(1.75%) 55(6.86%) 40(4.99%) 283(35.29%) 123(15.34%) 4.0~ 899(34.94%) 74(8.23%) 83(9.23%) 13(1.45%) 53(5.90%) 50(5.56%) 330(36.71%) 109(12.12%) 5.0~ 872(33.89%) 56(6.42%) 138(15.83%) 17(1.95%) 82(9.40%) 40(4.59%) 367(40.09%) 112(12.84%) Ages total 2573(100.00%) 235(9.13%) 315(12.24%) 44(1.71%) 190(7.38%) 130(5.05%) 980(38.09%) 344(13.37%) 2 0.45 18.21 9.84 9.31 4.09 P 0.799 0.000 0.132 0.010 0.129

results of Chongqing municipal survey in 2013(54.08%) 4. Conclusion and 2016(51.4%), respectively[9-10]. The results of this survey were lower than those of Chongqing and the The level of growth and development is one of the national a decade ago, which may be related to the choice important indicators to measure the nutrition and health of respondents. However, compared with other countries, status of children.Preschool period is critical for growth preschoolers in chongqing are still at a high level of caries and development.Balanced nutrition and healthy living prevalence.Like other findings, this study found no gender habits are especially important for the growth and differences in dental caries rates. This study found that the development of preschoolers. caries rate of rural children was higher than that of urban children. The reason for the difference may be related to the level of economic development of urban and rural areas, 4.1 Developmental Deviation of Preschoolers the attention paid by parents to oral problems and children’s living habits. Studies have shown that the caries in Chongqing rate of children aged 3-5 years in chongqing region basically increases by 10% with each year of age[10]. The Height, weight and BMI [4]are important indicators to survey also shows that there is significant age difference of reflect the growth, nutrition and health of children, and are caries rate, and increased with age.At present, the also the main monitoring contents of children's health comprehensive oral disease intervention program for services in China.This investigation showed that the preschool children in Chongqing (fluoride paint) is growth retardation rate was 13.06%, higher than the concentrated in three main areas (Yubei, Yuzhong, and national nutrition and health survey in 2012(3.2%)[5] and Shapingba). It can be considered to add intervention in the underweight rate was 12.24%, higher than the mid-term other areas to benefit more preschool children. Moreover, statistical monitoring report of the program for the the prevention and treatment of decayed decayed teeth development of Chinese children (2011-2020) in from 2 years old is helpful to strengthen the early 2016(1.49%)[6]. Rates of growth retardation and intervention of decayed teeth in preschoolers, so as to avoid underweight were also higher than that in other parts of the the aggravation of decayed teeth with age. country[7-8]. BMI is a neutral and reliable indicator that is The prevalence of anemia was 13.37%, higher than the commonly used in the world to measure the body result (4.79%)of the medium term monitoring and testing symmetry and health. This investigation showed that the reported of 2016 program on the development of children rate of emaciation was higher than Xi’an or Taizhou and in China (2011-2020)[6], and lower than that of the 2013 the rates of overweight and obesity were lower than Xi’an Chongqing survey[11]. In line with other findings[12], the or Taizhou[4][8]. In addition to gender differences in difference of anemia rate between urban and rural areas is underweight rate, there were no gender, regional or age large.According to the outline for the development of differences in growth retardation rate and body symmetry. children in China (2011-2020), the rate of anemia among Thus it can be seen that the body symmetry of preschoolers children under the age of five should be kept below 12% by in Chongqing is moderate, but the physical development is 2020.However, the prevalence of anemia in rural children not optimistic. Active measures should be taken to improve is much higher than this level. The nutritional status of the nutritional status of preschoolers and promote their children under 5 years old in China has always been physical development. significantly different between urban and rural areas, and the malnutrition rate of children in rural areas is higher than that in urban areas. This is mainly due to the imbalance 4.2 Caries and Anemia in Preschoolers in economic development between urban and rural areas. In Chongqing addition, the survey showed gender differences in anemia rates, which may be related to differences in dietary The dental caries rate of preschoolers was 38.09%, which preferences and physical development status between boys was lower than the statistical results of the 3rd national oral and girls. health epidemiology survey(64.34%),and lower than the

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4.3 summary of preschoolers in Beijing in 2015 (2005-2015) [J]. Beijing stomatology, 2017,25 (4) : 229-233. In summary, the physical development status of preschoolers in Chongqing was not optimistic. The rate of [4] Ma Fufen, Ma Liping, Cheng Xiangqun. Analysis growth retardation, underweight and overweight is higher of abnormal physical examination and deviation trend than the national level and some cities, and the prevalence of body mass index of preschool children in sanmen of dental caries and anemia is slightly lower than the county, taizhou city [J]. Practical preventive medicine, national level. Physical development, symmetry and common diseases all have some differences between urban 2016,23 (02) : 210-212. and rural areas. This is mainly because physical [5] Gu Jingfan. Results of the 2012 national nutrition development of preschoolers is influenced by various factors such as heredity, environment, nutrition, and health survey: the sixth national conference on diseases,among which the nutrition and growth nutrition of integrated traditional Chinese and western environment are especially important. In terms of nutrition, medicine [C]. Chongqing, 2015. children in urban areas are superior to rural areas, so the indicators of nutritional status of children in urban are [6] National bureau of statistics. Monitoring report superior to children in rural. In terms of growth on China's child development plan for 2016 environment, the living environment, learning conditions (2011-2020) [S]. 2017 and transportation modes of are quite different in urban and rural. In the final analysis, the difference of physical [7] Wang Fu-man, Jin xi, Yang qi, et al. Evaluation on development between urban and rural children is caused by the growth status of preschool children in China [J]. the imbalance of economic development between urban Chinese journal of preventive medicine, 2015,16 (06) : and rural area. Therefore, attention should be paid to 405-409. development of preschoolers in the process of growth and development and targeted measures should be used to [8] Ren Guiying, Zhang Ruijuan, Yang Weidong, et al. improve the physical development of children. Analysis of the status and related factors of physical development deviation and common diseases among 6595 preschoolers in xi 'an [J]. Chinese journal of child Acknowledgement health, 209,27 (07) : 768-770.

This research was financially supported by [9] Jang Lin Zhuang Qingming, Wang Jinhua , deng Research Project on teaching reform of higher jun, zhao rivers, He Songlin, li-na dai. Chongqing education in Chongqing. (Project NO. : 183115). preschool children caries disease condition Furthermore, thanks to all the kindergartens that investigation [J]. Journal of west China oral medical provided the data for this study. journal, 2014, 32 (5) : 472-475. [10] Wu Xiaoyan, Wang jingxue, Cai Ting, et al. Status References and influencing factors of decider-tooth caries in preschoolers in chongqing [J]. Chinese journal of [1] Cao Ying, Zhang Yalan, Liu Chunhua. An analysis stomatology, 203,37 (01) : 81-86. of the association between breast-feeding duration and overweight and obesity in preschoolers [J]. Chinese [11] Fang Hongyun, Yu Dongmei, Guo Qiya, et al. journal of child health, 2017,25 (11) : 1146-1149. Anemia in children aged 0 ~ 5 in China in 2013 [J]. China public health, 2008,34 (12) : 1654-1657. [2] Wang Weiping. Pediatrics [M]. Version 8. Beijing: People's Medical Publishing House, 2013. [12] Chang Suying, He Wu,Gu Fengme, et al. Chinese children 15 years changes in nutritional status analysis [3] Li Xin, Chen Wei, Zhang Hui, et al. Current [J]. Journal of health research, 2007, 36 (2) : 210-212. situation and 10-year changes of decayed teeth caries

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